Multi-Method Study of Electronic Health Records Workflows

Adela Grando, Areti Manataki, Stephanie K Furniss, Benjamin Duncan, Andrew Solomon, David Kaufman, Sarah Hirn, Robert Sunday, Joanne Bouchereau, Brad Doebbeling, Matthew M Burton, Karl A Poterack, Tim Miksch, Richard A Helmers

Research output: Contribution to conferencePaperpeer-review


EHRs transform work practices in ways that enhance or impede the quality of care. There is a need for in-depth analysis of EHR workflows, particularly in complex clinical environments. We investigated EHR-basedpre-operative workflows by combining findings from 18 interviews, 7 days of observations, and process mining of EHR interactions from 31 personnel caring for 375 patients at one tertiary referral center. We provided high-definition descriptions of workflows and personnel roles. One third (32.2%) of the time with each patient was spent interacting with the EHR and 4.2% using paper-based artifacts. We also mined personnel social networks validating observed personnel's EHR-interactions. When comparing workflows between two similar pre-operative settings at different hospitals, we found significant differences in physical organization, patient workflow, roles, use of EHR, social networks and time efficiency. This study informs Mayo Clinic's enterprise-wide conversion to a single EHR and will guide before and after workflow comparisons.

Original languageEnglish
Number of pages10
Publication statusPublished - 5 Dec 2018
EventAMIA 2018 Annual Symposium - San Francisco, United States
Duration: 3 Nov 20187 Nov 2018


SymposiumAMIA 2018 Annual Symposium
Country/TerritoryUnited States
CitySan Francisco
Internet address


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